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Bipolar I disorder with mood-incongruent psychotic symptoms

A comparative longitudinal study

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European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Objectives

The purpose of this paper is to demonstrate similarities and differences between bipolar I patients with and without mood-incongruent symptoms (MIS) over a long period of time, independently of longitudinal syndromatic constellations.

Methods

The Halle bipolarity longitudinal study (HABILOS) prospectively investigates 182 patients meeting the DSM-IV criteria for bipolar I disorders over a long period of time (x;− = 16.84 years). One thousand five hundred thirty-nine (1,539) episodes have been evaluated with standardized instruments. Patients and episodes were divided into two groups (with and without MIS) and were compared on various levels.

Results

It was found: (1) The majority of the episodes of bipolar I patients during long-term course did not have MIS, but the majority of patients did. (2) Bipolar I patients with MIS differ from patients without MIS in the following features: (a) Bipolar I patients with MIS are more frequently males. (b) Bipolar I patients with MIS need treatment at a significantly younger age than those without MIS. (c) First manifestation of bipolar I disorder with MIS after the age of 50 is extremely seldom. (d) Bipolar I patients with MIS more frequently have relatives with schizophrenia. (e) Bipolar I patients with MIS more frequently become disabled and retire at a significantly younger age than patients without MIS and (f) Significantly fewer patients with MIS than those without MIS live in a stable partnership.

Conclusions

It can be concluded that bipolar I disorders with MIS are more severe disorders than bipolar I disorders without MIS. This finding in combination with the above results, however, can give rise to the conclusion that bipolar I disorders with MIS are the epiphenomenon of the overlap, possibly genetic, of a “schizophrenic spectrum” and a “bipolar spectrum” and their antagonistic influence creating a “schizo-affective” area between them as a kind of psychotic continuum between prototypes.

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Authors and Affiliations

  1. Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik, Martin-Luther-Universität Halle-Wittenberg, 06097, Halle, Germany

    Andreas Marneros, Stephan Röttig & Dörthe Röttig

  2. Lindenweg 3, 06333, Hettstedt, Germany

    Andrea Tscharntke

  3. Bezirkskrankenhaus Kempten, Freudental 1, 87435, Kempten, Germany

    Peter Brieger

Authors
  1. Andreas Marneros
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  2. Stephan Röttig
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  3. Dörthe Röttig
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  4. Andrea Tscharntke
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  5. Peter Brieger
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Corresponding author

Correspondence to Andreas Marneros.

Additional information

Supported by grants of the DFG German Research Association MA 915/11-1.

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Marneros, A., Röttig, S., Röttig, D. et al. Bipolar I disorder with mood-incongruent psychotic symptoms. Eur Arch Psychiatry Clin Neurosci 259, 131–136 (2009). https://doi.org/10.1007/s00406-007-0790-7

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  • DOI: https://doi.org/10.1007/s00406-007-0790-7

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